药物洗脱支架置入术对老年冠心病冠脉不同病变程度患者斑块稳定性的影响  

Effects of Drug-Eluting Stent Implantation on Plaque Stabilityin Elderly Patients with Coronary Heart Disease

作　　者：陶林[1] 齐彬 王勇[1] 谭碧松 苗柳 TAO Lin;QI Bin;WANG Yong;TAN Bisong;MIAO Liu(Department of Cardiology,Liuzhou People’s Hospital,Liuzhou 545008,China)

机构地区：[1]柳州市人民医院心内科,广西柳州545008

出　　处：《标记免疫分析与临床》2021年第9期1526-1532,共7页Labeled Immunoassays and Clinical Medicine

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(编号:Z2019137)。

摘　　要：目的研究分析药物洗脱支架置入术对老年冠心病冠脉不同病变程度患者斑块稳定性的影响。方法选取2018年2月至2019年12月柳州市人民医院住院并成功行药物洗脱支架置入术的204例老年冠心病患者,并依据美国心脏病学会/心脏病协会(American College of Cardiology/American Heart Association,ACC/AHA)制定的相关诊断标准将不同病变程度的受试者分为单支组(n=82)、双支组(n=71)及多支组(n=51)。分别于术前及术后3 d,检测血清中斑块稳定性指标[内皮细胞特异性分子-1(Endocan)、半乳糖凝集素-3(Galectin-3)、脂肪素(Apelin)、组织蛋白酶K(cathepsin K,Cat K)]、脂质代谢指标[氧化修饰型低密度脂蛋白(oxidized modified low-density lipoprotein,ox-LDL)、前蛋白转化酶枯草溶菌素9(proprotein convertase subtilisin 9,PCSK9)、载脂蛋白A1(apolipoprotein A1,ApoA1)、载脂蛋白B(apolipoprotein B,ApoB)]、炎症因子[血管生成素样蛋白2(angiopoietin-like protein 2,ANGPTL2)、ANGPTL4、血小板趋化因子4(platelet chemotactic factor 4,CXCL4)和血小板趋化因子12(CXCL12)]及血管内皮功能指标[血管性血友病因子(von Willebrand factor,vWF)、6-酮-前列腺素(6-Reto-PGF1α)、一氧化氮(nitric oxide,NO)]。结果术后,单支组vWF、6-Reto-PGF1α、NO较双支组、多支组改善程度明显更大,且双支组亦较多支组改善程度更大(P<0.05);单支组ox-LDL、PCSK9、ApoA1、ApoB较双支组、多支组改善程度明显更大,且双支组亦较多支组改善程度更大(P<0.05);单支组ox-LDL、PCSK9、ApoA1、ApoB较双支组、多支组改善程度明显更大,且双支组亦较多支组改善程度更大(P<0.05);单支组Endocan、Galectin-3、Apelin、Cat K较双支组、多支组改善程度明显更大,且双支组亦较多支组改善程度更大(P<0.05)。结论对于老年冠心病患者而言,择期药物洗脱支架置入术能够在一定程度上造成血管内皮损伤,引发炎性反应,并可诱发患者机体脂质代谢�Objective To study the effect of drug-eluting stent implantation on plaque stability in elderly patients with different degrees of coronary artery disease.Methods We selected 204 elderly patients with coronary heart disease who were hospitalized in Liuzhou People’s Hospital from February,2018 to December,2019 and successfully underwent drug-eluting stent implantation.Based on the American College of Cardiology/American Heart Association(ACC/AHA)Related diagnostic criteria,these patients were divided with different disease severity into the single-vessel group(n=82),double-vessel group(n=71)and multi-vessel group(n=51).Preoperatively and 3 d after the operation,serum plaque stability indexes were detected[Endocan(Endocan),galectin-3(Galectin-3),alipin(Apelin),cathepsin K(Cat K)],as well as lipid metabolism index[oxidized modified low-density lipoprotein(ox-LDL),proprotein convertase subtilisin 9(PCSK9),apolipoprotein A1(ApoA1),apolipoprotein B(ApoB)],inflammatory factors[Angiopoietin-like protein 2(ANGPTL2),ANGPTL4,platelet chemotactic factor 4(CXCL4)and platelet chemotactic factor 12(CXCL12)]and vascular endothelial function indicators[von Willebrand factor(vWF),6-keto-prostaglandin(6-Reto-PGF1α),nitric oxide(NO)].Results After the operation,vWF,6-Reto-PGF1αand NO of the single-vessel group improved significantly compared with the double-vessel group and the multi-vessel group,and the double-vessel group also had a greater degree of improvement(P<0.05);Compared with the double-branch group and the multi-branch group,ox-LDL,PCSK9,ApoA1,ApoB of the single-branch group improved significantly,and the double-branch group also had more branches and the improvement was greater than the multi-branch group(P<0.05);For the single branch group,the improvement of ox-LDL,PCSK9,ApoA1,and ApoB were significantly greater than those of the double-vessel group and the multi-vessel group,and the double-vessel group also had more branches than the multi-branch group(P<0.05);For the single-vessel group,Endocan,Galectin-3,Apelin,C

关 键 词：老年患者 冠心病 药物洗脱支架置入术 斑块稳定性 

分 类 号：R541.4[医药卫生—心血管疾病]